Wiki wound care-muscle exposed

[LuckyLily]

I am trying to code for a non-pressure ulcer with muscle exposed. would this then be with 'fat layer exposed' or 'muscle necrosis'? The word necrosis is what's throwing me off. I associate it with gangrene.

If this is coded to 'muscle necrosis' would the subsequent visits always code out to muscle necrosis, since this is the worst stage it is. Or as the wound heals, does the coding change to that level? I know with pressure ulcers it stays at the worst level, but don't know if this applies to non-pressure wounds.

thanks

 

[CodingKing]

Id maybe query the physician. I wonder how long muscle could be exposed before necrosis starts to set in?

I went looking for the staging information and i can only find the guidelines for pressure ulcer. I did find a presentation online all about wounds (not icd related) that said the following in the pressure ulcer section. However, the wording to me sounds like its referring to wounds in general.

The body is unable to regenerate certain tissues (fat, fascia, muscle), therefore, reverse staging is inaccurate when used as a parameter for wound healing

Then again i ifound an article on medscape that says

The pressure ulcer staging system should not be used to describe other types of wounds, such as neuropathic foot ulcers, epidermal stripping, surgical wounds, or ulcers from venous or arterial insufficiency. Inappropriately using the NPUAP staging system to stage nonpressure ulcer wounds results in diagnostic inaccuracies and can have quality, economic, or legal ramifications.[3]

 

[rvalente]

I had a scenario like this today where the clinician stated, after removing eschar from the ulcer the joint was exposed. Because there was no documentation supporting the codes with necrosis, I went with unspecified. Good questions, hopefully someone can help us out ?